Annual report pursuant to Section 13 and 15(d)

Commitments and Contingencies (Details)

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Commitments and Contingencies (Details)
1 Months Ended 12 Months Ended
Dec. 27, 2018
USD ($)
Sep. 07, 2018
lawsuit
Dec. 31, 2018
USD ($)
Aug. 31, 2017
USD ($)
Dec. 31, 2018
USD ($)
Dec. 31, 2017
USD ($)
Dec. 31, 2016
USD ($)
Business Acquisition, Contingent Consideration [Line Items]              
Contingent consideration     $ 24,600,000   $ 24,600,000 $ 41,400,000  
Payment of SEC penalty $ 100,000   100,000        
Class action lawsuits | lawsuit   7          
Contingent membership interest       15.00%      
Credit line capacity     197,189,000   197,189,000    
Fixed purchase provisions     98,500,000   98,500,000    
Accrued Expenses              
Business Acquisition, Contingent Consideration [Line Items]              
Contingent consideration     2,400,000   2,400,000 11,800,000  
Other Long-term Liabilities              
Business Acquisition, Contingent Consideration [Line Items]              
Contingent consideration     $ 22,200,000   22,200,000 29,600,000  
BioReference              
Business Acquisition, Contingent Consideration [Line Items]              
Severance Costs         $ 4,900,000 $ 5,800,000 $ 17,900,000
Line of Credit | Veterans Accountable Care Group LLC              
Business Acquisition, Contingent Consideration [Line Items]              
Credit line capacity       $ 50,000,000.0      
Line of credit facility, expiration period       5 years      
Interest rate of notes payable       6.50%